Episode #204: Doug Hapeman and Matt Milford, “We Have This Vision Of Recreating Mental Healthcare With Technology To Make People Happier and Healthier”
Guests: Doug Hapeman and Matt Milford are co-founders of Foresight Mental Health, a startup that is revolutionizing mental healthcare through the use of modern technology, delivering highly personalized, data-backed treatment plans to each patient while helping psychiatrists prescribe medication more safely and effectively.
Date Recorded: 01/22/2020
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Summary: In episode 204, Meb talks with Foresight Mental Health co-founders Doug Hapeman and Matt Milford. They discuss Foresight’s origin story and the vision Doug and Matt had to apply technology to radically improve mental healthcare.
They get into the lack of technology adoption by psychiatrists that exists today, and what it took to build a fully integrated model from scratch to serve patients and healthcare providers.
The group even covers the patient and healthcare provider experience with Foresight and using data to drive a new standard of care.
All this and more in episode 204, including Doug and Matt’s most memorable investment.
Links from the Episode:
- 0:40 – Introduction
- 1:28 – Welcome to our guests Doug Hapeman and Matt Milford
- 2:11 – The origin of Foresight Mental Health
- 6:39 – Their initial approach vs how Doug and Matt landed on the current iteration
- 11:01 – Pursuing fundraising
- 15:21 – How Foresight differs from the traditional medical care setting
- 17:13 – Resources for people seeking treatment
- 18:09 – Convincing practitioners to join the platform
- 20:30 – The build out of the Foresight network
- 22:05 – Vision for Foresight
- 22:45 – What Doug and Matt learned about the process through data
- 25:13 – Treatment trends with Foresight clinics vs traditional clinics
- 26:43 – Ability for practitioners to customize their focus
- 28:40 – The approach to standard of care
- 30:58 – The business model
- 32:56 – Most memorable investments
- 34:08 – How to connect: foresightmentalhealth.com, linkedin for Douglas Hapeman and Matthew Milford
Transcript of Episode 204:
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Meb: Welcome, podcast listeners. We’ve got a great show for you today. Our guests are the founders behind Foresight Mental Health, a startup that is revolutionising mental health care through the use of modern technology, delivering highly personalised, data-backed treatment plans to each patient while helping psychiatrists prescribe medication more safely and efficiently.
In today’s episode, we discuss Foresight’s origin story and the vision our guests have to apply technology to radically improve mental health care. We get into the lack of technology adoption by psychiatrists that exist today and what it took to build a fully integrated model from scratch to serve patients and healthcare providers alike using data to drive a new standard of care. Please enjoy this episode with Foresight’s founders, Doug Hapeman and Matthew Milford. Welcome to the show, Doug Hapeman and Matthew Milford.
Matthew: Awesome. Yeah, thanks for having us. We’re really excited.
Meb: Well, guys, we’ve got a couple of Cal bears on the podcast. The last time I was in Berkeley, I’ve only played Frisbee golf like three times in my life, but there was a Frisbee golf course in Berkeley. I was playing with a buddy at business school and I went full tin cup. I don’t know if you guys saw the movie “Tin Cup,” but there’s a hole with some water. I must’ve lost 12 Frisbees on that hole and there was a little guy sitting there with some beers, selling beers and Frisbees, and they must’ve been like 10 bucks each, but he had the best business model of all time. I needed the services of your clinics afterwards because I was struggling that day.
Anyway, look, it’s great to have you guys. We’re gonna spend some time on your startup. This is gonna be a lot of fun. We’d love to hear a little bit about the origin story. Did you guys meet in CS 101 and concoct this idea? What were the beginnings?
Matthew: Yeah, absolutely. So Doug and I met at Berkeley. We were both studying in some of the same computer science classes. And yeah, as you can imagine, we had a lot of time in front of a whiteboard where, when we weren’t working, we’d be thinking about different problems in the world, specifically in healthcare that we could apply technology to really improve care. And so yeah, that was kind of the initial how we met and really developed our friendship and that kind of segued into Foresight pretty soon after that within a year.
Meb: And what was the inspiration? I mean, you guys just sitting and having coffee, having a beer, just shooting the shit and said, “You know what, I think mental health is an issue.” Or was it kind of just looking around at what’s going on in the community and the world, people walking around like zombies at the bus stop with their phones, what was the initial inspiration?
Matthew: Yeah, well, definitely both of us have some personal interest in mental health care and this might come across as a bit dark after those two points, but I was actually studying abroad in Nice, in France when I got interested in mental health care. For Bastille Day, there was a pretty big event for watching fireworks just down on the promenade. And if you’re familiar with the event, there was a large terrorist attack that happened that night. Our truck came and careened into about 80 people and killed them. One of which…one of those individuals was my good friend and a number of other of my friends were hit by the truck.
Coming back to Berkeley, seeing the mental illness from that event, almost everyone had depression, anxiety, PTSD, trauma, as you can imagine, understandably. Seeing them trying to find a therapist or psychiatrist was really horrific, honestly. Like most of them were getting on three-month waiting lists, paying hundreds of dollars out of pocket. The quality of care that was received, I mean this treatment approach is decades outdated and really in need of a new methodology of treatment. So seeing that was my personal interest in mental health care and both Doug and I were really passionate about applying technology to fix this problem. So that was kind of the genesis concept.
Meb: All right. So walk me forward. So you guys said, “Look, this is something that there’s potentially a need for.” Was it a scenario that you guys kind of went through the process and said, “Man, this doesn’t feel right, it’s broken”? Was it something that you just started to study? How did kind of the company actually get it start?
Doug: Yeah, so the first part there was just learning and absorbing everything we could about the market deficiencies, kind of the gold standard is in mental health care today. So we spent months and months leveraging resources at Berkeley, talking to professors, lab directors, people in the industry. We first were looking at an approach. We knew access and affordability were big issues. We first wanted to tackle the care itself. We found it to be really lacking, as Matt was touching on, really based in our cake methods and diagnosing treatment selection and monitoring. We first got started with…
Meb: Just to interrupt you real quick, because the way that I think about it, I have plenty of friends that are psychiatrists and therapists of various forums and I don’t have that deep of an experience personally with this sort of model. But what I have in mind, I feel like what a lot of people have in mind is something almost like “Good Will Hunting,” where it’s someone you’re like straight out of Freud laying down on a couch or laying down on a bed, someone’s asking questions, you don’t really know what’s going on. It seems sort of philosophical, almost. Is that sort of like an accurate representation or is that totally off? What is sort of the standard of care that you saw maybe a mismatch to the opportunity?
Doug: Yeah, I mean that’s pretty close. We met with hundreds of psychiatrists in person throughout this kind of discovery phase and, yeah, it’s this dialogue, Q&A type process. Like how are you feeling today? How has that changed over the last couple of weeks? How have you been sleeping? And yeah, it’s just very based on this like qualitative, conversational type interaction. Yeah, I mean advances in healthcare that we’ve seen in other fields leveraging technology and data just aren’t there at all for mental health care. Yeah. On a side note, “Good Will Hunting” is one of my favorite movies of all time, so I appreciate the reference there.
Meb: So, okay, you guys kind of did like an initial assessment and then your initial idea, I think, is a little different than actually what you’re doing today. Maybe kind of walk us through that whole process of actually getting the company started and what was the initial approach.
Doug: First we were looking at treatment selection, specifically in medication selection. So we were working on bringing precision medicine into mental health care and into psychiatry. So analysing a number of factors about the patient, the individual, and assisting the psychiatrist in prescribing medication more safely, more effectively. So yeah, that was the original entry point and, yeah, through that process we met with and interviewed hundreds and hundreds of psychiatrists and really dove deeper into what this market actually looks like day to day. What are they doing today in diagnosing and understanding the individual and mental state of the individual in front of them, how they go about selecting treatment, and then continuing to monitor and track the efficacy of treatment that’s being performed.
Meb: It’s funny you guys mentioned that because my background is actually also as an engineer as a biotech guy, and when I was in grad school over a decade ago, the thing that I remember being a project for a class was a very similar issue where so many patients would not get screened at all for, in this example, is how they metabolise the drugs. And so having people that were fast metabolisers and slow metabolisers in the process seem so antiquated, where they would prescribe a medicine to know if you have an adverse reaction, well maybe we’ll prescribe less or, hey, if it’s not working, we’ll prescribe some more, and that seemed a bit odd in the 21st century. Okay. Talk to me a little bit about how the initial uptake was. How’d you guys go about actually starting to roll this idea out?
Doug: Yeah, in hindsight, I think we were focused a little bit too much on building the technology. At the beginning we both have also engineering backgrounds, so we worked for awhile on building out the technology platform and then, yeah, kind of we’re working on a bunch of customer development, learning about how this fits into workflows and incentives and stuff like that. So yeah, we were going kind of one by one in this very fragmented mental health care landscape, very bottoms up, just meeting a bunch of people, demoing, getting them on board, on the platform. That was the approach we were taking there.
Matthew: Just one thing to add on there. A like obvious approach that we could have taken would be going towards like why not go towards a network of providers like a health system. In the end we did. The pushback we received was these providers have an electronic medical record like Epic so getting them to change their clinical workflows or jump onto a new system during patient interactions is incredibly challenging. That’s the problem many digital health companies face so we felt a easier go-to market strategy, at least initially was these kind of solo practitioners, which unsurprisingly also proved challenging due to many of the same problems.
Meb: All right. So walk us through as far as timeline. What year is this? Where are you guys in the process? Are you still in school?
Doug: So computer science classes, Matt was talking about, that was, let’s see, fall of 2016 and, yeah, that kind of initial research and learning phase was that fall. And then, so we were still in school at that point. We worked on developing the product and platform over that winter and spring, and then worked on it full time over the summer. So that was summer 2017. And then, yeah, focusing on that go-to market strategy there throughout the summer and fall of 2017. So yeah, that’s something we worked on a full time and we were really, really working hard. We kind of came to the realization that looked like this is something we want to continue to pursue. There’s just absolutely no way we could spend the amount of time we were spending on the company and take classes on top of it. So that summer we were working really hard and finally, yeah, I made the decision that we’ll take a semester off to see how it goes and then continue to decide either way, go back to taking classes or continue working working on it full time.
Meb: Was that the point once you guys decided to pursue fundraising?
Doug: Yeah, it was that fall then going into the winter there.
Meb: And what was that process? I mean, what was the decision there? I mean, did you say, “Look, we clearly need to raise some money for this. We can’t bootstrap it.” What was kind of the idea genesis?
Matthew: Yeah. I mean we were working for free and like a lot of sweat equity obviously at this point, and people were working on our team for very low wages because they believed in the vision that we had, and that’s just not financially viable to operate with or realistic to operate with that mentality. We raised capital of 500K to really build out our feature set on our product and then get to market. Obviously we ended up pivoting, which we’re getting to, but that 500K was able to deliver the first clinical setting that we had.
Meb: All right. You guys raised a little money, starting to build your team, what’s next?
Matthew: Yeah, yeah, absolutely. We raised 500K and leveraged that capital to really drive the sales funnel. Ran through a lot of…well, we unearthed a lot of problems in mental health during that process. We found that a lot of psychiatrists were very reluctant to change their clinical behaviors, specifically getting onto new software systems, utilising new digital health tools. Yeah, really huge lack of infrastructure, actually.
I mean, most of the psychiatrists we talked with in the Bay area, one of the most high tech areas in the world didn’t even have a computer in their office. So deploying software infrastructure without the computers already being in the offices was really challenging, as you can imagine. Like not only are you dealing with typical digital health go-to market problems, there’s just a complete lack of technology infrastructure to support what we were building. And we realised if we wanted to fully grasp our vision across this disparate network of psychiatrists, the only way to do it would be a fully integrated model where we just start from scratch and have the providers directly on staff. So that’s when we pivoted around the end of spring, early summer of 2018.
Meb: Was that pretty painful at the time? Was it a situation where like, “Dude, we just dropped out of school. This is clearly like whatever it is, is kind of the product-market fit maybe is not there or it’s just we’re going to try something else”? Was that a tough time? Was that an easy decision?
Mathew: Yeah. To give you a sense of how excruciating that was, imagine working many, many, many all nighters, 12, 15 hour days for a year straight and having little to no success with product delivery. Even with initial proof points of, wow, this is a technology that could actually change psychiatry and the market’s just not ready for anything like that. So absolutely excruciating. And, yeah, flipping into a new model is no easy decision by any means and a lot of people thought we were crazy going from like a lean software approach to what appears to be a capital intensive like brick and mortar business.
Meb: And were most of the investors, at this point, they’re just like, “Hey, you guys go pound sand. We didn’t sign up for this”? Were they supportive? What was the reaction?
Matthew: I think generally our investors have been really supportive of us and, yeah, I mean, credit to them, this was a huge new endeavor, virtually a completely new model. Although we were still leveraging the software we developed at the core, completely new business application with a lot of learnings to be made. And so we spent that whole summer working extremely aggressively and hard on learning how to go ahead and launch a clinic and our first clinic launched in Berkeley in July of 2018.
I mean we knew it would be successful because we’d seen the supply-demand imbalance. There’s just this ridiculously high demand for mental health care services, unmet need, especially on the insurance side. I mean people are paying hundreds of dollars out of pocket if you’re able to accept insurance and see them, there’s gonna be a need for that. But really what we’d created was an ecosystem now that we could develop new digital health applications, breakthrough modules to change both what data is collected, how it’s structured and standardised, and also the actual treatment delivery.
Meb: Maybe walk me through to the extent you can that is not proprietary but from someone who’s been to obviously doctors in various settings my whole life, having experienced the one medical model, walk me through kind of what it’s like for someone that shows up to one of these clinics or take it from the provider standpoint, what are the big differences? What is the key? When you say technology, that means that a lot of things to a lot of people, but whether it’s the tests, whether it’s how the whole process works, what can you kinda describe that would be different than a traditional old school setting?
Matthew: We have a lot of digital touch points with the patients outside of the clinical setting, which is very atypical in a market or industry where it’s largely non-continuous measurement. We’ve also managed to drive a lot of objective data to track outcomes. And, again, a few that’s largely based on qualitative, subjective data for outcome measuring and have developed a number of our own modules and partnerships with companies working on both diagnostic systems and treatment recommendation engines. So those are a few of the areas we’re playing around in and have significant technology that we’ve developed.
Meb: And so if someone’s listening to this and they have either personally, a friend, a family member that’s interested in treatment, what are the current resources that you would recommend today? Is it something that you can log into, go to Foresight, find a clinic, set up an appointment? Is that sort of the recommended? And I don’t even know at this point, is it almost universally covered by insurance? Is it never covered by insurance? What’s the typical standard of payment?
Doug: Yeah, we’re covered by just about every insurance company. And so yeah, it just comes down to typically a $15, $20 copay per visit.
Meb: And so as far as resources for the people that are interested in seeking treatment that probably haven’t, you guys did quite a bit of research and study going into this. What sort of any recommendations, any process that you think would be helpful?
Doug: The first step is just to get help, and the individual needs to be on the same page, want to get better, want to get healthier and happier. Typically, if you’re trying to use insurance as most people would like to do, insurance plans are a good resource to go to. They usually have online portals where you can search for covered providers in your area. And yeah, that is a first step. Just find someone that will take your insurance, that’ll drive the costs down significantly. And yeah, that would be my recommendation. But yeah, first, certainly recognise too that you’d like to get help and then, yeah, go from there.
Meb: So I talked to so many of my friends that are psychiatrists and you have what you mentioned earlier, which is a supply-demand imbalance where I think I saw on your deck that it’s something like 20% or 25% of the population could be eligible for some sort of mental illness treatment, but very few people actually treat it. But despite those large numbers, there tends to be a pretty strong demand for psychiatrists. So what is the main gating factor of, so you started to build this, you had a clinic, how do you convince therapists to actually join? What’s in it for them? What’s kind of the big benefits of this tech-enabled structure?
Matthew: Yeah, I mean attracting talent, I think, is a huge competitive advantage we have over most health services companies or health systems. We have this vision of recreating mental healthcare with technology to make people happier and healthier, and that vision is unique and we’ve had tangible steps towards that providers get extremely excited about. So we have huge volume of people interested in joining Foresight as a result.
Meb: What is sort of the…I assume you guys are hiring. As you expand, partnering, how does it work? Is it a partnership? Is it something where…how does the traditional model set up with the therapist or psychiatrist you guys employ?
Doug: You know, we work really closely with our providers on developing these technology-based and data-driven solutions. So our network of providers really gives us quite an advantage in developing some of these solutions. Like we currently have about 60 providers on our team and they each have specialties and interests that whether it’s sleep or exercise or some more esoteric treatment method that we can then take, develop that into a digital health solution, and expand that expertise, and expand that knowledge across the organisation so everyone can have access to that particular specialty or specific knowledge that maybe they’ve picked up in their education process, their experience in the clinic. And yeah, really take that knowledge and proliferate it throughout the organisation. And that’s just an example of enabling our providers with best in class knowledge or tools that then can be used to treat every Foresight member.
Meb: And so you started with one clinic, you now have more than one clinic. Talk to me a little bit about the whole build out process.
Matthew: Yeah. We’re up to now about 12 clinics and growing extremely rapidly on that front. But yeah, I think that’s something we’ve really figured out pretty well, developed methodologies now for launching clinics. And yeah, it’s something we’ll continue to do for the next couple of years. Launching a clinic is no easy business. It took us a lot of time to figure out how to do that, but yeah, I think one area we are strong in is the capital efficiency at which we launched these clinics and it is a unique differentiator. Most health services companies launching new clinics is upwards of $500 to $2 million to build out a clinic. For us, it’s a lot cheaper than that, like a 10X difference.
Meb: We find ourselves now walk forward 2019, 2020, the year’s over. The decade is upon us. You started to raise some more money last summer?
Matthew: Yeah, we started around like April. In hindsight, not the best time to raise at the summer. That ended up going exceptionally well, attracted a lot of great investors on board, and that capital we raised about 1.3 million, and that allowed us to scale from 1 to 12 clinics.
Meb: Awesome. This is a California story at this point, you guys across the country?
Matthew: We’re not a national group at the moment, but yeah, that’s something we’re interested and excited about the opportunity to help more individuals. Right now we’re based in California, though.
Meb: So you’re obviously early stages. This is something you’re gonna give a go for a while. Talk to me a little bit about what’s the eventual vision for this. As you look out to the horizon, what’s the future look like?
Matthew: Creating a new standard of mental health care, leveraging technology to drive access and affordability through lower level providers or rather no psychiatrist essentially because there’s a huge shortage. I mean definition of technology enabled-services by leveraging lower level providers with technology without sacrificing on quality of care. That’s our vision is to proliferate this new standard of care for diagnosing, treating, and monitoring patients, and driving immensely better outcomes at a lower cost.
Meb: And what’s on the flip side? Say you’re a therapist and so you guys are pretty early in the process, but I imagine eventually a benefit of this sort of approach is that you start to have access to a fair amount of data sets. And I imagine there’s probably not a whole lot that you can actually divine from the amount of sessions you’ve had already, maybe you can. And so I would love to hear about it.
Are there any major levers that you think are different than traditional? So maybe it’s like, “Hey, we noticed that the outcomes of using meditation and exercise actually have a far greater impact than we thought, or maybe that actually the prescription of antidepressants is too widespread or too much or not enough.” Is there anything in general that you can talk to? I mean, I know you guys aren’t psychiatrists, but as far as the whole process that you said, “Oh, man, this is interesting, it’s starting to be some insights from all the data we’re collecting.”
Matthew: Yeah, yeah, absolutely. I mean, you’re hitting on the nail right there. I mean we have this data set, we can start to identify patterns and drive insights to the point of clinical care on cohorts of similar patients who receive medication X and see positive outcomes or negative outcomes and drive changes in clinician decisions based on that. Similar things can be said for exercise, sleep, and how they impact mental health symptoms. And then on the flip side, actually identify new biomarkers to detect potential best treatment options or shifts in mental state. So a number of different objective data streams that we’re looking at among which include wearables and, yeah, that data can really drive a new standard of care.
Meb: Well, the wearables, I mean I’m just curious where we are in that sort of knowledge base. So it’s sorta like the genome sequencing. You’re starting to get some mentioning information. How useful at this point 2020 is the wearable information and what sort of data is particularly interesting from the wearable standpoint?
Matthew: Yeah. I’ll touch on some of the questions that I can speak to. The wearable like exercise and sleep data specifically, I mean exercise and sleep are huge impact confounding variables in mental health, lots of clinical research on that, validating this approach, but the exciting part here is really more continuous quantitative data on those two pieces. Whereas today it’s largely discontinuous and qualitative data.
Meb: And it seems like a fair amount of patients are simply medicated today, whether it’s with just antidepressants or any other medications. Do you have any general thoughts on y’alls clinics versus a typical clinic, and I’m sure there’s some templates of what the standard prescriptions and status are. Is it something that you see any particular trends that stand out where you’re like, “Hey, actually because of our approach, people are less medicated or they have different medications, or it’s a cocktail approach.” Or, in fact, you know, I saw very in your early days you talked about drug interactions where patients may not even be screened for some of the interactions that would be harmful. Is there any general kind of thoughts or takeaways on that topic?
Matthew: Yeah, definitely. I mean, we’re able to show clinical efficacy reducing severe to mild symptoms in just five visits. This isn’t a randomised controlled trial, so it’s difficult to compare, but contracting with the industry today, that’s exceptional. I mean just with psychotropic medications, 40% of the first antidepressants given don’t even work and it takes 6 weeks to figure that out.
So right away you’re seeing huge strides towards improved care and that’s largely driven by inventing this new standard of care and getting the best in class providers. Looking at the cost effectiveness, I think that’s an area we’ll really start to aggregate more and more data on as we scale. But yeah, again, treating people faster at the end of the day is cheaper.
Meb: And how is the general sort of company philosophy? Because I imagine if you contract with a bunch of different therapists, they’re gonna have different approaches. How much of this is sort of a top down, like one voice for the firm where you’re like, “Look, this is our approach, this is what we do,” and how much of it is actually bespoke customised to the actual therapists? Because I imagine if you were to go to five different therapists from five different companies, you’d have probably five totally different approaches and prescriptions and diagnosis. I mean maybe not totally different, but is that something you’d try to make it a firm-wide experience or is it something that you give them pretty wide berth on being able to customise their own sort of practice?
Mathew: Yeah, phenomenal understanding, like, what it looks like today. I mean, you go to different providers, you often could get a different diagnosis or treatment path that you get funneled into. Outcome measuring is different from provider to provider, and part of what we’re building is really this way to objectively, in a standardised way, assess patients and figure out the optimal treatment path.
That being said, within our provider group, there’s absolutely individuals with different specialisations. And how that works today is personal practice experience, and individual training really drives a lot of their treatment methodologies, and then our technology enhances that. But as we continue to scale, ideally we’re able to extract those insights from their personal practice experience and proliferate them throughout our network of providers leveraging our software platform as a medium to do so.
Meb: Yeah. And, you know, it’s just curious because you look at so much of the world today where there is quantitative objective evidence about something. I mean this is obviously not related, but the NFL coaches that objectively should make certain play calls, particularly the fourth down and punting is a good example, but that clearly just don’t do what’s in their best interest for various behavioral reasons.
What is the approach of standard of care? So if you look back say 50 years ago, the USDA used to have the food pyramid that said you’re supposed to eat 10 servings a day of cereal and bread and pasta. And whether you think that’s inverted or different now, it’s certainly not stuff your face with processed foods and sugars. How has sort of this foresighting in corporate, new peer reviewed knowledge and standard of care? Is it driven from sort of your advisors where it’s Jerry or Kelly? Is it driven by any sort of process that you guys put in place? How does that knowledge base grow?
Matthew: How do we deliver these new insights to the point of care that we’re starting to identify or extract from personal practice experience? So there’s a number of different ways we can deploy those insights. One is our precision medicine software, so that’s at the point of prescription decision-making. So starting to integrate historic data into that as well as a new literature that’s coming out, that can be leveraged in real time for prescription decisions across our network of prescribers.
On the diagnostic side, similar, but just a different module. So we’re looking at some of our technology modules there, we can integrate new streams of data into the same user interface, which is already being used today to drive more accurate and comprehensive diagnostics.
Meb: So vision for the future. Walk me through 2025, 2030, what’s the world look like? How are things going to change for you guys? What’s on your mind?
Matthew: Yeah, I think what we really at the core of what we’re doing is a couple of points. One is driving affordable and accessible mental health care. So being able to get into a provider rapidly and without having to pay hundreds of dollars out of pocket, at a baseline that’s definitely something we want to hit on.
Driving more of a science rather than an art into mental health care as to leveraging data and technology to standardise more of the diagnosing process, recommending treatments, and then also defining how to define an outcome in mental health care. So that’s an area we’re looking to reinvent. And then finally, comprehensiveness in treatment services. Right now it’s largely solo practitioners, a lot of siloed information, so aggregating this data across the network and being able to provide comprehensive treatment services is an area of key interest.
Meb: And for clarification, is your current model where you’re charging the patient and then the insurer, is it just a per appointment model or is it a monthly subscription model? How does it actually work?
Doug: Yeah. Right now it’s a fee for service model with the insurance company. Yeah, we’re exploring different avenues there. Value-based care is becoming a hot topic in healthcare. We certainly think that trend will continue and we’re excited to see that transition to mental health care.
Meb: I just wonder like, you know, as we look to the future, I mean particularly so many people in y’alls demographic but also older generations too, theoretically if you’re really good at what you guys do, it’s actually probably a negative for the business model because you may not have to see the therapist so much. But rather if you have all these touch points of, “Hey, look, I’m now incorporating exercise and better nutrition and I can check in via, I don’t know, just saying like a one medical model,” you can check in via chat or email or text based that you may not actually have to go into the appointments. The main driver is actually this wellness. It will be curious to see how that evolves over the years because theoretically if you guys are really good, you may not need to see the therapist as much in the future. I don’t know. It’s an interesting kind of idea.
Doug: Yeah. We, like I said, are very excited for mental health code to shift to like at risk value based models and we think we’ll be well positioned to take full advantage of that and, yeah, exactly what we want people to be healthy and happy and not coming in for appointments.
Meb: Because the traditional therapist charges what? Like it’s like lawyer fees for the insurance companies. It’s like 500 bucks an hour or something?
Matthew: Yeah. Psychiatrists can be up there. Just therapists are a hundred or a couple of hundred up to.
Meb: Interesting. Yeah cause I mean theoretically if you’re an insurance company and you say, “Hey, look we have a patient, but the wellness would be even better if they weren’t coming.” Anyway, I’m just curious thinking about it but cool. We ask everyone this, you guys are on the founders series but because it’s an investment podcast we ask anyway and we’d love to hear what both of y’alls most memorable investments have been if you’re even involved that much in investing at your age. Were you guys crypto guys? What’s been the most memorable investments over the years?
Doug: I went through a crypto…well, I guess I’m still in it. I invested a little bit, made it a ton, and then I have settled back down to a little bit again. So it would have been a great investment. We’ll see, but, yeah, I’m sure a lot of people have encountered that experience.
Matthew: Yeah, I definitely have a similar experience in crypto, but yeah, I mean Tesla’s doing well, I guess.
Meb: This is a position you own or have or just curious?
Matthew: Yeah, I mean obviously at our age, nothing significant or substantial. I’m personally fairly Porsche on Tesla despite many financial analysts shorting it.
Meb: A hundred billion company this week, so they must be doing something right. Look, guys, I think this has been interesting, helpful. Where do people find out more information if they’re curious from any standpoint if they are interested in treatment, if they’re interested in partnering with the company as an employee, if they’re interested in an investment, where do people go find out more about you guys? What you’re up to?
Doug: foresightmentalhealth.com is where we are online. And then LinkedIn probably for Matt and I would do the best place for us directly.
Meb: Well, gents, thanks so much for taking the time today.
Doug: We appreciate it. Thanks, Meb.
Meb: All right, listeners, shoot us an email or firstname.lastname@example.org. We love listening to feedback. Give us a review. Subscribe to the show on iTunes Breaker, which in my current favorite. Thanks for listening, friends, and good investing.